Oklahoma's Department of Corrections (ODOC) provides mental health care to state prisoners through dedicated Mental Health Units and Intermediate Care Housing Units, governed by ODOC Operational Procedure OP-140127 ("Mental Health Units, Intermediate Care Housing Units, and Habilitation Programs"), last updated December 31, 2024 -- making it one of the most recently revised mental health housing policies in this series.
Oklahoma's state mental health agency, the Department of Mental Health and Substance Abuse Services (ODMHSAS), partners with ODOC on mental health programming, medication-assisted treatment, and community reentry services. In December 2024, ODOC launched a Medication-Assisted Treatment (MAT) reentry program through this collaboration.
Oklahoma also has a pending legal situation that directly affects its mental health infrastructure. A lawsuit over long wait times for competency restoration services for people in the criminal justice system who are too mentally ill to stand trial has generated a potential consent decree. The Oklahoma Legislature set aside $4.1 million in FY 2025 funding specifically for costs related to this potential consent decree.
Oklahoma does not have active federal court oversight specifically of ODOC prison mental health care.
What Oklahoma Prisoners Are Entitled To
Under Estelle v. Gamble (1976), Title 57 of the Oklahoma Statutes, and ODOC policies including OP-140127:
- Mental health screening at intake.
- Mental health services in designated Mental Health Units and Intermediate Care Housing Units for prisoners with serious mental illness.
- Mental health services at all ODOC facilities based on assessed needs.
- Access to ODMHSAS-partnered programs and services.
- Crisis intervention and suicide prevention.
- Pre-release planning for mental health continuity upon release.
Mental Health Screening at Intake
ODOC conducts health screening for all incoming prisoners, including mental health assessment. The screening identifies mental health history, current diagnoses, and active psychiatric medications. Prisoners with serious mental illness are assessed for placement in appropriate mental health housing.
If your person has a psychiatric history, provide documentation at intake -- prior hospitalizations, diagnoses, and active medications -- to support accurate classification and medication continuity.
Mental Health Units and ODOC OP-140127
ODOC Operational Procedure OP-140127 ("Mental Health Units, Intermediate Care Housing Units, and Habilitation Programs"), last revised December 31, 2024, governs the operation of mental health housing within ODOC. The policy covers three distinct housing types for prisoners with behavioral health or developmental needs:
Mental Health Units (MHUs): Specialized housing for prisoners with serious mental illness requiring structured mental health programming and treatment in a dedicated unit. Mental health staff provide intensive services within the unit.
Intermediate Care Housing Units (ICHUs): A step-down level of mental health housing for prisoners who have progressed from a Mental Health Unit but still need a structured, supportive housing environment before returning to general population. Intermediate care housing provides continued mental health support at a lower intensity than the MHU.
Habilitation Programs: Specialized programming for prisoners with developmental disabilities or other habilitation needs who require specialized support.
The policy's December 31, 2024 revision date reflects ODOC's current operational framework. Families should ask which type of housing unit -- MHU, ICHU, or general population -- their person is currently in, and what the criteria are for placement in each level.
Mental Health Services at ODOC Facilities
In addition to specialized MHU and ICHU housing, ODOC's medical/mental health division provides services to prisoners throughout the system:
- Mental health assessments and evaluations.
- Individual and group counseling.
- Psychiatric medication management.
- Crisis intervention and suicide prevention.
- Case management for prisoners with serious mental illness.
- Reentry planning including connection to ODMHSAS and community mental health services upon release.
A specific percentage of ODOC prisoners are estimated to have a serious mental illness -- this figure is sourced from ODOC itself (specific percentage should be confirmed at publish from current ODOC data).
The ODOC-ODMHSAS Partnership
The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) is Oklahoma's primary state behavioral health agency. ODMHSAS received approximately $387 million in FY 2025 appropriations -- a 7.8% increase from the prior year -- reflecting the state's investment in behavioral health infrastructure.
ODOC and ODMHSAS work together on:
Mental health programming: ODMHSAS provides clinical expertise, consultation, and partnership on mental health programs within ODOC.
Medication-Assisted Treatment: The December 2024 MAT reentry program was developed through ODOC-ODMHSAS collaboration.
Community reentry: ODMHSAS's network of community mental health centers and crisis services is the primary community-side resource for people being released from ODOC with mental health or substance use needs.
ODMHSAS operates community mental health centers across Oklahoma's counties, crisis stabilization units, and diversion centers that serve as the community mental health safety net for people leaving ODOC.
The December 2024 MAT Reentry Program
In December 2024, ODOC launched its Medication-Assisted Treatment (MAT) reentry program in collaboration with ODMHSAS. Key facts:
- The program was launched in mid-December 2024.
- It was developed through ODOC/ODMHSAS collaboration, with ODMHSAS guiding the incorporation of medication into ODOC's substance use treatment program design.
- The program is funded through a U.S. Department of Justice Bureau of Justice Assistance Residential Substance Abuse Treatment (RSAT) grant.
- The program has been recognized nationally.
MAT provides FDA-approved medications (such as methadone, buprenorphine, and naltrexone) combined with counseling to treat opioid and alcohol use disorders. The reentry focus means the program is specifically designed to support people as they transition from ODOC custody back to the community, providing a bridge to community-based MAT services.
For prisoners with opioid or alcohol use disorder approaching release, ask whether the MAT reentry program is available at their facility and whether enrollment has been initiated.
The Competency Restoration Lawsuit
Oklahoma has a pending lawsuit and potential consent decree related to wait times for competency restoration services. People in the Oklahoma criminal justice system who are found to be too mentally ill to stand trial are entitled to competency restoration services. However, wait times for these services have been a documented problem, with people waiting in county jails for extended periods before receiving treatment.
The 2025 legislative session was considering a proposed consent decree to resolve this lawsuit. Oklahoma's FY 2025 budget (HB 2929) set aside $4.1 million to use "in the event of a 'consent decree' that could resolve a lawsuit against the department regarding competency restoration services."
Additionally, $500,000 was appropriated for five pilot programs to provide MAT for opioid and alcohol dependence to people in county jails.
This lawsuit targets ODMHSAS, not ODOC directly. However, it affects the pipeline of people who may eventually enter ODOC, and the competency restoration infrastructure affects many people in the justice system with serious mental illness in Oklahoma.
ODMHSAS Community Mental Health Centers
Upon release from ODOC, prisoners with mental health needs connect with ODMHSAS's network of community mental health centers (CMHCs) and behavioral health providers across Oklahoma's counties. Oklahoma's CMHCs provide:
- Outpatient mental health services.
- Crisis stabilization.
- Medication management.
- Peer support and recovery services.
- Case management.
State Questions 780 and 781 (passed by Oklahoma voters in 2016) reclassified some drug possession and low-level property crimes as misdemeanors and directed the cost savings from fewer incarcerations to counties through the County Community Safety Investment Fund -- which counties must use for mental health, substance use, and criminal justice diversion programs. This funding stream supports the community-side infrastructure that ODOC prisoners connect with upon release.
What Families Can Do
If your person is in ODOC custody and has a mental illness:
Provide psychiatric history at intake. Supply documentation of prior hospitalizations, diagnoses, and active medications to support accurate mental health classification and medication continuity.
Know OP-140127. This is the December 2024 revised ODOC policy governing Mental Health Units, Intermediate Care Housing Units, and Habilitation Programs. Ask which type of housing your person is in (MHU, ICHU, or general population) and what the criteria are for each level.
Know the MHU placement right. If your person has serious mental illness and is in general population without MHU placement, ask whether an MHU evaluation has been conducted. Ask what the criteria for MHU placement are under OP-140127 and whether your person meets them.
Know the ICHU step-down. If your person is leaving or has left an MHU, ask whether ICHU placement has been considered as a step-down before returning to general population.
Know the MAT program. If your person has opioid or alcohol use disorder and is approaching release, ask whether the December 2024 MAT reentry program (ODOC/ODMHSAS collaboration, DOJ/BJA funded) is available at their facility and whether enrollment has been initiated.
Know the competency restoration situation. If your person is still in a county jail awaiting competency restoration services (not yet sentenced to ODOC), the pending consent decree and lawsuit may be relevant. Contact Disability Rights Oklahoma for advocacy.
Ask about ODMHSAS reentry connections. Ask what community mental health center has been identified in the county where your person will be released, whether a first appointment has been arranged, and whether medication continuity is planned.
File a grievance. ODOC has an administrative grievance process. File formal grievances for: failure to conduct mental health screening, denial of MHU or ICHU placement when warranted, medication interruption, MAT program access denials, and failure to initiate reentry mental health planning.
Contact Disability Rights Oklahoma. DRO (drokc.org) is the federally mandated Protection and Advocacy organization for Oklahoma and monitors conditions for people with mental illness and disabilities in ODOC facilities.
Seek legal help. If your person has serious mental illness and is not receiving appropriate mental health housing under OP-140127, or if mental health services are being denied, consult a prisoner rights attorney with experience in Oklahoma's federal courts (Eastern, Northern, and Western Districts of Oklahoma).
Frequently asked questions
How does Oklahoma screen prisoners for mental illness?
ODOC conducts health and mental health screening for all incoming prisoners at intake, identifying mental health history, diagnoses, and active psychiatric medications. The screening drives placement in appropriate mental health housing -- Mental Health Units (MHUs), Intermediate Care Housing Units (ICHUs), or general population with mental health services. Provide psychiatric documentation at intake -- prior hospitalizations, diagnoses, and active medications.
What mental health units does ODOC operate?
ODOC's OP-140127 (last revised December 31, 2024) governs three specialized housing types: Mental Health Units (MHUs) for prisoners with serious mental illness requiring intensive structured treatment; Intermediate Care Housing Units (ICHUs) as a step-down level for prisoners transitioning from MHUs before returning to general population; and Habilitation Programs for prisoners with developmental disabilities or other habilitation needs.
What is ODOC's Intermediate Care Housing program?
Intermediate Care Housing Units (ICHUs) provide a step-down mental health housing option between the intensive Mental Health Unit and general population. ICHUs offer continued mental health programming and support at a lower intensity than MHUs, designed for prisoners who have progressed through intensive mental health treatment but still need structured support before returning to general population. ICHU placement is governed by ODOC OP-140127, last revised December 31, 2024.
What is the ODOC-ODMHSAS mental health partnership?
ODOC partners with the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS), which received $387 million in FY 2025 appropriations. ODMHSAS provides clinical expertise and partnership on ODOC mental health programming, guided the development of the December 2024 MAT reentry program, and operates the community mental health center network that ODOC prisoners connect with upon release. The two agencies collaborate on treatment design, reentry programming, and community behavioral health continuity.
What is ODOC's MAT reentry program launched in 2024?
In mid-December 2024, ODOC launched a Medication-Assisted Treatment (MAT) reentry program in collaboration with ODMHSAS, funded through a DOJ Bureau of Justice Assistance RSAT grant. The program provides FDA-approved medications (for opioid and alcohol use disorders) combined with counseling, specifically designed to support people transitioning from ODOC custody to the community. ODMHSAS guided the incorporation of medication into ODOC's substance abuse treatment design. The program has been nationally recognized. Ask whether the program is available at your person's facility.
What is Oklahoma's competency restoration lawsuit about?
A federal lawsuit alleged that Oklahoma's wait times for competency restoration services -- for people found too mentally ill to stand trial -- were unconstitutionally long. Oklahoma's FY 2025 budget set aside $4.1 million to address costs related to a potential consent decree resolving this lawsuit. A separate $500,000 was appropriated for MAT pilot programs in county jails for people waiting for services. The 2025 legislative session was considering a proposed consent decree. This lawsuit targets ODMHSAS, not ODOC directly, but affects the pipeline of people with serious mental illness moving through Oklahoma's justice system.
What mental health services does ODOC provide generally?
ODOC provides throughout the system: mental health assessments and evaluations, individual and group counseling, psychiatric medication management, crisis intervention and suicide prevention, case management for prisoners with serious mental illness, and pre-release reentry planning connecting prisoners to ODMHSAS community mental health services. Specialized services are provided in Mental Health Units and Intermediate Care Housing Units under OP-140127.
How does Oklahoma handle mental health care at release?
ODOC's reentry planning connects prisoners with ODMHSAS's network of community mental health centers (CMHCs) across Oklahoma's counties. The December 2024 MAT reentry program specifically addresses the transition for people with opioid or alcohol use disorders. For people with mental illness approaching release, ask what CMHC has been identified, whether a first appointment has been arranged, and whether medication continuity is planned. The County Community Safety Investment Fund (from State Questions 780/781) provides county-level mental health and diversion resources that may be available post-release.
What can families do if mental health care is denied in OK?
Provide psychiatric documentation at intake. Know OP-140127 (December 2024) and the three housing levels (MHU, ICHU, Habilitation). Ask whether MHU or ICHU placement has been evaluated. Know the December 2024 MAT reentry program -- ask about enrollment for SUD approaching release. Ask about ODMHSAS CMHC connections approaching release. File ODOC grievances for placement denials, medication interruptions, and reentry planning failures. Contact Disability Rights Oklahoma (drokc.org) for legal advocacy.
Who oversees mental health care in Oklahoma prisons?
ODOC's Health Services Division manages mental health services system-wide under OP-140127 and related operational procedures. ODMHSAS partners with ODOC on treatment design and community reentry. No federal court currently exercises active oversight of ODOC prison mental health. Disability Rights Oklahoma (DRO, drokc.org) is the federally mandated P&A organization monitoring conditions for people with mental illness and disabilities in ODOC. The pending competency restoration consent decree may establish some ODMHSAS oversight mechanism -- verify at publish. ---